Department of Health and Social Care

Vaccination

Baroness Ritchie of Downpatrick: To ask His Majesty's Government, with reference to declining immunisation rates in the UK, what level of prioritisation the Department of Health and Social Care and the UK Health Security Agency are giving to the adoption of new immunisation programmes with high uptake.

Lord Markham: The introduction and adoption of new immunisation programmes and achieving high uptake across all immunisation programmes remains a high priority for the Government. We achieve high uptake for both life-course and seasonal vaccinations, with over 90% for pre-school diphtheria, tetanus, and pertussis and among the highest in the world for flu vaccination. The NHS COVID-19 vaccination programme has been the biggest vaccine drive in the history of the National Health Service, implementing the largest volume of new vaccines in the shortest time, and repeatedly with boosters. 157.5 million COVID-19 vaccinations were delivered in England from December 2020 to the end of January 2024. However, over the last decade, performance across routine immunisation programmes has been in decline and continued variation in uptake and coverage between different communities reflects wider health inequalities.In response to these challenges, the NHS vaccination strategy builds on lessons learnt from the pandemic and the success of our routine immunisation programmes. It aims to maximise uptake and coverage of vaccinations across all communities, improving uptake to save more lives.

Dementia: Diagnosis

Baroness Goudie: To ask His Majesty's Government what steps they are taking to ensure that the NHS is prepared for the arrival of new diagnostic innovations for dementia.

Lord Markham: The National Health Service is a world leader in rolling out innovative treatments and has established a dedicated national programme team which is working in partnership with other national agencies and with local health systems to prepare for the potential roll out of new treatments for use in the earlier stages of Alzheimer’s disease. These plans assume that, if these new treatments are approved by the regulators, significant additional diagnostic capacity, including amyloid positron emission tomography–computed tomography, lumbar puncture and magnetic resonance imaging, will be needed both to identify patients who are most able to benefit and to provide important safety monitoring.The national programme team is conducting preparations across the country, working alongside clinicians and local teams to identify where further funding will be required to roll out the additional tests and services needed to introduce these new and complex treatments.NHS England is also working with partner agencies to support and inform further research into other diagnostic modalities, including blood-based biomarker and digital tests, which will help improve identification and management of Alzheimer’s disease.

Mental Health: Children

Baroness Hollins: To ask His Majesty's Government what plans they have to improve the mental health and wellbeing of babies and very young children, especially given the evidence surrounding the cumulative impact of poor mental health outcomes that begin early in life.

Lord Markham: In March 2021, the Government published The best start for life: a vision for the 1,001 critical days, a copy of which is attached. This vision sets out six action areas for improving support for families during the 1,001 critical days to ensure every baby in England is given the best possible start in life, regardless of background.The Government is investing approximately £300 million to improve support for families through the joint Department of Health and Social Care and Department for Education Family Hubs and Start for Life Programme. The programme is implementing many elements of the Best Start for Life Vision and is delivering a step change in outcomes for babies, children and their parents and carers in 75 local authorities in England, including those with high levels of deprivation. This investment includes £100 million for bespoke perinatal mental health and parent-infant relationship support. Many local authorities without funding have also chosen to implement elements of the vision.The_best_start_for_life (pdf, 11030.4KB)

Magnetic Resonance Imagers: Helium

Baroness Bennett of Manor Castle: To ask His Majesty's Government whatsteps they are taking to ensure minimal usage of helium in MRI scanners in NHS facilities in the light of the global shortage of helium; and what steps they are taking to ensure all helium in scanners being replaced is reused appropriately.

Lord Markham: Suppliers of magnetic resonance imaging (MRI) scanners are moving to a sealed helium solution, whereby the helium required to cool the magnet is approximately 0.5% of the current levels. These sealed systems will also ensure MRI scanners do not require further helium to be added during years of operational use.Furthermore, suppliers are now replacing MRI scanners without requiring the magnet to be replaced, though this is only available for the first replacement cycle, whereby the scanner is fully replaced, but the existing magnet and helium are retained.With regards to the Department, as set out in the recent Medical Technology Strategy: One Year On publication, the Design for Life Programme has been stood up to work with industry, the health and care sector, and academic partners to develop medical technology systems that support reuse, remanufacture, and material recovery becoming the default. This includes developing regulatory, commercial, digital, and policy environments that support this aim. The Department’s intention is to publish a roadmap later this year to articulate our relevant findings and plans moving forward.

General Practitioners

Lord Birt: To ask His Majesty's Government what plans they have toreview the convenience and efficacy of the systems used by NHS GP practices for patients to make an appointment to see a doctor.

Lord Markham: We published our Delivery plan for recovering access to primary care in May 2023, which sets out how we are moving toward a ‘Modern General Practice’ model. This plan is backed by £240 million of retargeted funding going to provide digital services with the goal of increasing access. A copy of the plan is attached.The sole method for general practices (GPs) to procure these digital services is via NHS England procurement frameworks, which list pre-approved suppliers for digital and IT services. This is to ensure consistency in service provisions, as each supplier must meet a set of requirements to be entered into a framework.Each practice will run a procurement for these services and will select a supplier based on their differing specifications for how the IT systems will best meet their patients’ needs. Each supplier will offer varied services with varied benefits, including capabilities which allow patients and service users to request and receive support relating to healthcare concerns, at a time and place convenient for them.As of March 2024, 93% of general practices now have digital telephony systems, this has enabled GP teams to manage multiple calls and helping to end the ‘8am rush’ for appointments. Trials show that this has increased patients’ ability to get through to their practice by almost a third.Delivery plan for recovering access (pdf, 896.8KB)

Disease Control

Baroness Jones of Moulsecoomb: To ask His Majesty's Government what steps they are taking to ensure that the proposed WHO Pandemic Preparedness Treaty, due to be considered by the 77th World Health Assembly in May, will include provisions to improve indoor air quality.

Lord Markham: The United Kingdom welcomes the Pandemic Accord as an opportunity to strengthen global health security. Improving indoor air quality remains an important issue in public health. However, as the Accord aims to establish a high-level framework for pandemic prevention, preparedness and response, we have pursued action on this specific issue in other multilateral settings.The UK continues to support international improvements to indoor air pollution through its engagement with the World Health Organization (WHO). For example, the UK Health Security Agency (UKHSA) contributed to WHO projects in 2020 and 2022 to assess combined exposure to multiple chemicals in indoor air in schools. UKHSA continues to work with the International Society on Indoor Air Quality and Climate on the development of an open database on international indoor environmental quality guidelines. The database aims to be actively used by researchers, practitioners, and policymakers across the world.Moreover, the UK was a strong advocate for action to improve indoor air quality at last year’s United Nations General Assembly. We worked with international partners on this issue during the High-Level Meeting on Universal Health Coverage. The UK was supportive of reference being made to the health impacts of indoor air pollution, which was subsequently adopted in the meeting’s political declaration on 5 October 2023, and is available on the United Nations website in an online-only format.

Food Data Transparency Partnership

Baroness Jenkin of Kennington: To ask His Majesty's Government, followingthe Food Data Transparency Partnership’s decision not to make reporting on health data mandatory, what steps they are taking to ensure enforcement of and consistency in the voluntary scheme.

Lord Markham: The Food Data Transparency Partnership’s (FDTP) Health Working Group (HWG) has been testing the effectiveness and quality of potential standardised metrics that food and drink companies can use to report on the healthiness of their sales. This is an important part of government’s strategy to address poor diet and reduce obesity and was restated in the Major Conditions Strategy interim report August 2023. Once a recommended set of metrics and reporting guidance has been produced and approved by Ministers, the expectation is that businesses who voluntarily report will all follow this standardised approach.A key commitment of the HWG is timely and transparent communication so that wider food sector stakeholders can input into each stage of the process in order to ensure recommendations around comparability and enforcement will be as viable and effective as possible. Alongside engagement with industry, the FDTP also regularly engages civil society organisations and investor groups to gather and integrate wider feedback into discussions. Summaries of these HWG discussions are published online on the FDTP GOV.UK page.

Nutrition

Baroness Jenkin of Kennington: To ask His Majesty's Government what steps they are taking to tackle diet-related ill-health, including type 2 diabetes and heart disease.

Lord Markham: We remain committed to promoting a healthy diet for adults and children and are delivering an ambitious programme of work to create a healthier environment to help people make healthy food choices to improve health and to tackle diet related ill health. There are a range of measures in place to support improving diets, promoting physical activity and reducing obesity.Regulations on out of home calorie labelling for food sold in large businesses, including restaurants, cafes and takeaways, came into force in April 2022. Restrictions on the placement of products high in fat, sugar or salt in key selling locations, came into force on 1 October 2022.  We will be implementing restrictions on the sale of less healthy products by volume price such as ‘3 for 2’ and will introduce restrictions on the advertising of less healthy products before 9pm on TV and paid for less healthy product advertising online from 1 October 2025.We are working with the food industry to make further progress on reformulation and ensure it is easier for the public to make healthier choices. The Food Data Transparency Partnership will help enable and encourage food companies to voluntarily demonstrate progress on the healthiness of their sales.The Government continues to promote the Eatwell Guide principles through the NHS.UK website and government social marketing campaigns such as Better Health Healthier Families and Start for Life. We are also supporting more than three million children through the Healthy Foods Schemes and helping schools boost physical activity to help children maintain a healthy weight and good overall health through the Primary School PE and Sport Premium and the School Games Organiser Network.We are continuing to support local authorities to improve the uptake of the NHS Health Check, England's cardiovascular disease prevention programme. The NHS Health Check helps to prevent a range of conditions including heart disease and type 2 diabetes. Each year the programme engages over 1 million people and prevents around 400 heart attacks or strokes.

Health Services and Social Services

Lord Swire: To ask His Majesty's Government what progress they have made on integrating social care and the NHS.

Lord Markham: The Health and Care Act 2022 established integrated care systems, reforming how health and adult social care work together by putting partnership at the heart of planning. The Government has published guidance for integrated care partnerships (ICPs), on the statutory requirement for each ICP to publish an Integrated Care Strategy to address the health, social care, and public health needs of their system. All ICPs have now published their integrated care strategies.The integration of health and social care is often best achieved through collaboration across smaller geographies within integrated care systems called places. Since the Health and Care Act 2022, we have seen good progress in the development of place-based arrangements to integrate health and social care. In October 2023, we published our Shared Outcomes Toolkit designed to help place-based partnerships develop shared outcomes as a powerful means of promoting integrated working and joined up care. We also issued a call for evidence as part of our review of Section 75 of the NHS Act 2006, which permits local authorities and National Health Service bodies to pool budgets, enabling joint commissioning and the commissioning of integrated services. The findings of this review will be shared in due course.

Suicide: Coastal Areas

Lord Hunt of Kings Heath: To ask His Majesty's Government, with reference to research by Christine Camacho and Luke Munford at the University of Manchester showing that deaths from drugs, alcohol and suicide are higher in northern and coastal local authorities, what steps they are taking to address that regional inequality.

Lord Hunt of Kings Heath: To ask His Majesty's Government, with reference to research by Christine Camacho and Luke Munford at the University of Manchester, what steps they are taking to reduce regional inequalities in what those researchers refer to as "Deaths of Despair".

Lord Markham: The Levelling Up the United Kingdom white paper sets out the Government’s ambition to improve living standards and wellbeing across the UK, invest in communities, and improve public services. It sets mutually reinforcing levelling up missions to focus Government action, including a health mission to narrow the gap in healthy life expectancy by 2030, and increase healthy life expectancy by five years by 2035.The Government has published a 10-year drug strategy and is investing an extra £532 million between 2022/23 to 2024/25 to improve drug and alcohol treatment and recovery services. This funding is being used by local authorities to create places for an additional 54,500 people in drug and alcohol treatment services and bolster the workforce, seeking to prevent nearly 1,000 deaths. This funding is being targeted to areas of highest need first.The Department is increasingly focusing on supporting local areas, including better meeting the needs of vulnerable groups. Current work includes: providing targeted support to local areas; enhancing data tools to better inform local needs assessments; supporting workforce development; implementation of the commissioning quality standard; and sharing good practice. Implementation support will adapt over the course of the 10-year strategy in response to need, to ensure we reach the drug strategy goals.We also published our new Suicide Prevention Strategy for England in September 2023, setting out the actions we will take to save lives and reduce suicides within the next few years, and have set out our intention in the strategy to write guidance for local areas to support them in aligning their own strategies with the national strategy. We have also established a £10 million Suicide Prevention Grant Fund to run from 2023 to March 2025, and on 4 March 2024 we announced the 79 organisations across the country that have been allocated funding. We have also launched a new nationwide, near real-time suspected suicide surveillance system, that will improve the early detection of, and timely action to, address changes in suicide rates or trends.

Respiratory Syncytial Virus

Baroness Ritchie of Downpatrick: To ask His Majesty's Government what data they are gatheringon countries currently implementing immunisation programmes for infant respiratory syncytial virus regarding (1) acceptance and uptake, and (2) hospitalisations.

Lord Markham: The UK Health Security Agency continues to monitor international reporting. In the United States, as of 31 January 2024, maternal immunisation was 17.9%. By February 2024, 43% of infants under eight months old had received a dose of nirsevimab.In Galicia, Spain, 92.9% of 5,357 infants born between 25 September 2023 and 4 February 2024 had nirsevimab, plus 79.7% of 5,823 in a catch-up programme. The peak of hospitalisation rate in infants under six months old was 102 per 100,000, for season 2023 to 2024 during the week starting 27 November 2023 compared to a median of 776 for seasons 2017 to 2018, 2018 to 2019 and 2019 to 2020, peaking during the first week of January 2024.In Luxembourg, 84% of 1,524 infants born in hospital between early October and mid-December 2023 received nirsevimab. Luxembourg observed a decrease in hospitalisation in infants under six months old of 69% between the 2022 to 2023 and 2023 to 2024 respiratory syncytial virus seasons.

Ministry of Justice

Prison Sentences

Lord Blunkett: To ask His Majesty's Government what specific budget is allocated for the implementation of the current Imprisonment for Public Protection action plan.

Lord Bellamy: HM Prison and Probation Service is using existing resources to deliver the requirements of the IPP Action Plan, ensuring that it is used to best effect to support those serving IPP sentences to achieve their sentence plan objectives and reduce their risks. HMPPS does not allocate funding in such a way as it would be possible to disaggregate specific amounts dedicated to sentence planning, offender management and support for IPP offenders.Unto that end, the Action Plan focuses on ensuring offenders can access the required services or interventions in order to take positive steps towards a future release, a sustainable life in the community and, ultimately, the end of their sentence altogether. Further, when it comes to those serving the IPP sentence in prison, the Action Plan requires that they have an up to date sentence plan and are held in a prison which provides the intervention(s) specified in the sentence plan. It is expected that the latest IPP Annual Report and Action Plan will be published in mid-May.We have taken significant action through the Victims and Prisoners Bill to curtail IPP licence periods to give offenders the opportunity to move on with their lives. In addition to these changes, the actions this Government is taking are working; the number of prisoners serving the IPP sentence who have never been released now stands at 1,180 as of 31 March 2024, down from more than 6,000 in 2012.

Injunctions

Lord Rogan: To ask His Majesty's Government how many super-injunctions are currently in effect in England and Wales.

Lord Bellamy: There is currently one super-injunction in force which was made in the Kings Bench Division of the High Court.

Treasury

Advance Pricing Agreements

Lord Sikka: To ask His Majesty's Government how many advance transfer pricing agreements have been signed by HM Revenue and Customs in each of the past five years.

Baroness Vere of Norbiton: HM Revenue and Customs has entered into the following number of advance pricing agreements in the past five tax years:2018 to 2019: 302019 to 2020: 262020 to 2021: 242021 to 2022: 202022 to 2023: 15This information is included in the Transfer Pricing and Diverted Profits Tax Statistics 2022 to 2023 which are publicly available and published on gov.uk[1]. [1] Transfer Pricing and Diverted Profits Tax statistics 2022 to 2023 - GOV.UK (www.gov.uk)

National Insurance Contributions

Baroness Lister of Burtersett: To ask His Majesty's Government, further to the Written Answer byBaroness Vere of Norbiton on 8 April (HL3589), whether they will now answer the question put; namely,what is their assessment of the implications for calculating entitlement to contributory working age benefits and pensions of abolishing, rather than cutting, national insurance contributions.

Baroness Vere of Norbiton: The Government already cut employee NICs by 4p, self-employed NICs by 3p and abolished the requirement to pay Class 2 for self-employed people across Autumn and Spring without increasing borrowing or cutting spending. That is the model the Government wants to follow when it is prudent to go further. The ambition to abolish NICs is about reducing tax and rewarding work, not about reforming the contributory benefits system. It is a long-term ambition, and the Government has been clear, this cannot be done overnight and this can only be done in a fiscally responsible way. Cutting NICs rates does not affect anyone’s entitlement to the State Pension or contributory benefits.

UK-EU Trade and Cooperation Agreement

Lord Leigh of Hurley: To ask His Majesty's Government, further to remarks byBaroness Vere of Norbiton on 21 February (HL Deb col 666) with regard to the Trade and Cooperation Agreement in the context of engaging with the EU for approvalfor extending the enterprise investment scheme (EIS) and venture capital trust (VCT) scheme, whether the subsidy control provisions of the Trade and Cooperation Agreement apply to EIS and VCT relief, in particular the requirement under Article 363 of that agreement that a subsidy must be selective.

Baroness Vere of Norbiton: The government is extending the sunset clause for the Enterprise Investment Scheme (EIS) and the Venture Capital Trust (VCT) scheme to 2035.The UK-EU Trade and Cooperation Agreement is now the primary framework governing subsidy control between the UK and EU. As such, EU State aid rules no longer apply to the UK, save for the limited circumstances covered by the Windsor Framework.For the EIS and VCT schemes, the government is engaging with the EU, under the Windsor Framework, due to Northern Ireland’s unique access to the EU Single Market.